Activity Labelling: Revolutionising Our Public Health

Monday, September 18th, 2017

Overweight and obesity are growing global concerns that should be tackled as soon and as best as possible. One solution could be through activity equivalent calorie labelling, which would open consumers’ eyes to their daily caloric intake and encourage them to make healthier choices. By Shirley Cramer CBE, chief executive, RSPH

The UK, along with many other nations around the world, is facing an obesity epidemic. Around two thirds of adults in the UK are now overweight or obese, and these already worrying statistics look set to worsen over coming decades, with some predictions estimating that 60 percent of men and 50 percent of women in the UK will be obese by the year 2050.

Similarly in Asia, though the region presently has a generally low prevalence of overweight and obesity, these numbers in recent years are climbing at an alarming rate as well with the boom in economic development and cultural factors driving them. In fact, recent research is showing that the region’s prevalence for these two conditions are catching up fast to that of the West.

This is clearly an unsustainable situation. The health consequences of obesity, including diabetes, heart disease and cancer are already placing a tremendous strain on our health services. If current trends continue, we may be facing a very serious situation where our health service is no longer able to cope with the pressures being placed on it from entirely preventable illnesses and diseases related to obesity.

The causes of obesity are complex and multiple and we recognise that there is no silver bullet. However, the underlying issue is that people are consuming far more calories than they are expending. Addressing this will require a wide range of different policy measures, and we must recognise that action at all levels, not just from the individual is required.

First and foremost, the environment that people live in and interact with on a daily basis has to be changed in order for there to really be an impact on consumers. Education is also required so consumers know and understand what constitutes a healthy and well-balanced lifestyle.

In providing individuals with the tools to make healthy choices, it is essential that the information which is presented to people is as accessible as possible, without being too oversimplified. The most important thing is that the information presented is made use of to support healthier lifestyles.

Activity Equivalent Calorie Labelling—A Solution?

Perhaps, one way to encourage consumers to make the right food choices would be the introduction of activity equivalent calorie labelling for food and beverages. Proposed by RSPH early this year, the idea is simple; packaging would display small pictorial icons showing how many minutes for a range of different activities it would take to ‘expend’ the calories contained within the food or drink. The activities could include walking, jogging, running, cycling, swimming, etc.; activities that are accessible to most consumers.

On average, consumers only spend around six seconds looking at food packaging before they purchase. This is a very small window of time to take in complex nutritional information and make a healthy decision to buy product ‘A’ over product ‘B’. It has also been shown that the public prioritise calorie information when looking at the nutritional information that is provided to them.

Further, academic research also shows that people understand symbols far better than numerical information alone, particularly for lower socioeconomic groups who often lack nutritional knowledge and health literacy. For example, the calories in a can of fizzy drink take a person of average age and weight about 26 minutes to walk off. Given its simplicity, activity equivalent calorie labelling offers a recognisable reference, accessible to everyone without the need for any formal nutritional knowledge.

Activity equivalent calorie labelling may be one initiative that could contribute, as part of a wider effort, to the battle against overweight and obesity. However, obesity will not be reduced by focusing on diet or physical activity alone. People need to create a balanced relationship between the calories they consume and the calories they expend. Placing information on food and drink packaging to promote an active lifestyle could be a logical solution to a multifaceted problem.

Labelling Concerns

There have been some concerns raised about activity equivalent calorie labelling. Firstly, not every person expends calories in the same way. A 50 kg female will expend calories differently compared to a 100 kg male doing exactly the same activity. However, activity labels would be based on an ‘average adult’, much in the same way that recommended calorie intakes (2,000 kcal for women, 2,500 kcal for men) are based on a typical female and male adult.

It would therefore be up to individuals to deduce their own needs based on their age, weight, height and other variables and the implementation of activity equivalent labelling would need to be accompanied by consumer education. This might be a little confusing for consumers who do not understand or are unaware of how generic this labelling is.

Another concern that has been raised regarding activity labelling is the potential for those suffering with eating disorders, such as anorexia, to become even more obsessive with burning off calories to a dangerous extent. While this is recognised as a very serious concern and there is the chance that the label might encourage people to have a disordered relationship with food and physical activity, the biggest public health challenge at present still stands: the obesity epidemic and health problems associated with lack of physical activity. The implementation of activity equivalent labelling would likely still benefit the larger majority.

A Required Change Supported By Consumers

So why the change? Current labelling efforts appear to be ineffective. There is little evidence that front-of-pack information in its present form, including traffic light labelling in various countries, is having any impact in positively changing behaviour. Consumers are also suffering from ‘information overload’, where there is too much complex information to process in the short space of time people look at food packaging.

The obesity problem has got to such a point that labelling can no longer just provide information in the form of grams and percentages, although this is still useful. Packaging and labelling must be utilised to have a tangible impact. The food industry must play an active voluntary role in this progression to avoid the need for legislation.

Ultimately, the objective of activity equivalent calorie labelling is to encourage people to be more mindful of the calories they consume, how these calories relate to people’s everyday lives and to encourage them to be more physically active.

In a research by RSPH, the public indicated they would be three times more likely to choose a healthier product, eat a smaller portion of the product or undertake physical activity as a result of viewing activity labels. This sort of change should not be something the industry should be wary of; rather it could be an opportunity for food manufacturers and retailers to provide their customers with better information and the information that consumers actually want.

At present however, food and packaging manufacturers may appear unenthusiastic to trial or research new ways to express nutrition information to consumers, partly because of legislative barriers, and also partly due to concerns about how this could impact on sales.

Despite this, an estimated two thirds (63 percent) of the public are backing the introduction of activity equivalent calorie labelling. It seems that with this high level of support, this type of labelling is a great opportunity for the food industry to convey information to consumers in a way that works for them.

Implementing In The Near Future

Introducing activity-equivalent calories labelling should be a fairly simple step. Today, the calories contained in many food and drink items are displayed, so all that is required is equating these to activity equivalents. Doing this would not require legislation. Already, there are one or two food companies already doing it in the UK. Retailers or food companies could therefore show some real leadership on this issue—and contribute to making consumers’ lives healthier.

Food labelling is currently governed by European legislation in the UK. Recent regulations have come into force requiring mandatory nutrition declarations for most pre-packaged food—so there is little appetite, certainly in some circles, for further changes. This is again where food manufacturers could lead the way and pioneer trials or pilot what works best for their consumers and provide information in a way that works for ordinary people trying to improve their health.

If we are to take forward activity equivalent calorie labelling there should be extensive and thorough consultation with the food industry and consumers to determine which would be the most effective way of presenting this information and to tease out some of the issues or unintended consequences.

Possible ideas include on the front of food and drink packaging, on food manufacturers’ websites or via smart phone apps. For example, recent apps where users can scan the barcodes of products to instantly view their sugar content have proved to be extremely popular.

Whichever form activity equivalent information may take, it is important that the information is easy for consumers to understand and also effectively positively influences people’s behaviour. The food industry has a responsibility to play its part in the fight against obesity; it cannot just be left to health services and public health advocates.

With previous movements, the public has grown used to being told to avoid particular drinks and cut down on certain foods. By contrast, what is great about activity labelling is that it encourages people to start something, rather than calling for them to stop. It is a positive message that can be applied to food and drink labels, rather than a negative warning sign.